ArticleLife (Basel, Switzerland)2025
Electrocardiographic Abnormalities in Elderly Patients Receiving Psychotropic Therapy in the Emergency Department: A Retrospective Cohort Study.
Article in Life (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPsychotropic medications are frequently prescribed to elderly patients in emergency settings, yet their potential to induce electrocardiographic (ECG) abnormalities, particularly QTc interval prolongation, raises safety concerns. Older adults may be especially vulnerable due to polypharmacy, age-related cardiac changes, and comorbidities.
methodsWe conducted a retrospective observational study on patients aged ≥65 years who underwent psychiatric evaluation in the Emergency Department (ED) of a tertiary hospital between 2015 and 2023. Data was extracted on demographics, psychiatric symptoms, psychotropic drug use, and ECG findings. The primary outcome was the prevalence of major ECG abnormalities (QTc or QRS prolongation), and secondary analyses explored associations with drug class and hospitalization.
resultsSeventy-seven patients were included (62.3% female, median age 74 years). Overall, 22.1% exhibited ECG abnormalities, with QTc prolongation in 16.9% and QRS widening in 5.2%. ECG alterations were more common among patients receiving psychotropic drugs (30.7% vs. 13.2%;
conclusionsECG abnormalities are common in elderly patients undergoing psychiatric assessment in the ED and seem associated with psychotropic medication use. However, non-pharmacological factors also contribute significantly to risk. Integrated multidisciplinary evaluation is essential to ensure both psychiatric and cardiovascular safety in this fragile population.
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